Cherrington J M, Fuller M D, Lamy P D, Miner R, Lalezari J P, Nuessle S, Drew W L
Gilead Sciences, Inc., Foster City, CA 94404, USA.
J Infect Dis. 1998 Dec;178(6):1821-5. doi: 10.1086/314487.
Blood culture isolates from patients receiving first- (peripheral retinitis) or second-line (relapsing retinitis) therapy with intravenous cidofovir were obtained from three clinical trials for in vitro antiviral susceptibility analyses. Isolates from 6 patients obtained after 14.3 weeks (mean) of first-line cidofovir therapy showed complete susceptibility to cidofovir, ganciclovir, and foscarnet. Isolates from 20 patients were obtained after 17.3 weeks (mean) of second-line cidofovir therapy. Ten showed complete susceptibility to all inhibitors, 3 showed low-level ganciclovir resistance (<6-fold) but were sensitive to cidofovir and foscarnet, and 7 showed moderately reduced susceptibility (<8-fold) to cidofovir and high-level resistance (8- to 23-fold) to ganciclovir in vitro. Four of these 7 isolates showed reduced susceptibility (4-fold) to foscarnet. Notably, there was no difference in time to retinitis progression in patients that were on cidofovir therapy when sensitive isolates were compared with those showing reduced susceptibility to cidofovir in vitro.
接受静脉注射西多福韦一线治疗（周边性视网膜炎）或二线治疗（复发性视网膜炎）的患者的血培养分离株，取自三项临床试验，用于体外抗病毒药敏分析。一线西多福韦治疗14.3周（平均）后获得的6例患者的分离株，对西多福韦、更昔洛韦和膦甲酸钠完全敏感。二线西多福韦治疗17.3周（平均）后获得20例患者的分离株。10例对所有抑制剂完全敏感，3例显示对更昔洛韦低水平耐药（<6倍），但对西多福韦和膦甲酸钠敏感，7例在体外显示对西多福韦敏感性中度降低（<8倍），对更昔洛韦高水平耐药（8至23倍）。这7例分离株中有4例对膦甲酸钠敏感性降低（4倍）。值得注意的是，在体外将对西多福韦敏感的分离株与对西多福韦敏感性降低的分离株进行比较时，接受西多福韦治疗的患者视网膜炎进展时间没有差异。
